Mary Lyn Oetter, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05175 Issued in IA

Practice address

101 E 22ND St
Atlantic, IA 50022-2800

Phone

(712) 254-9018

Fax

(712) 254-9019

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heartland Family Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Council Bluffs, IA
  • NPI 1972343184

  IA

  Medicare reassignment NPD
• Heartland Family Service

  • Multi-Specialty Clinic/Center
  • Council Bluffs, IA
  • NPI 1447742036
  NPD
• Heartland Family Service

  • Professional Counselor
  • Council Bluffs, IA
  • NPI 1710136841
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1720117815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "PANAMA",
            "state": "IA",
            "postal_code": "515620001",
            "telephone_number": "712-254-9018",
            "fax_number": "712-254-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 22ND ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500222800",
            "telephone_number": "712-254-9018",
            "fax_number": "712-254-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETTER",
        "first_name": "MARY",
        "middle_name": "LYN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Neuharth, MA, MHC
• Jennifer R Nevins, MS, LMHC, NCC
• Andrew John Niemann, ATC
• Nishna Valley Dental
• Nishna Valley Mental Health
• Mark Oleson
• Christopher Olsen, ARNP
• Elizabeth Anne Olsen, MS, RD, LD
• Joanne Olsen, RN
• Timothy J Pafford, CADC

• All providers in Atlantic, IA
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.